Approximately 10 percent of hearing aid wearers have 10 dB loss of ability to understand speech in noise, in the sense that they require a signal-to-noise ratio 10 dB better than normal-hearing listeners. Since at many restaurants and social gatherings the normal- hearing listeners themselves are forced to carry on conversations near the limit of their ability, those with a 10 dB or greater "SNR loss" are left out of the conversation. Being left out of normal social interaction often leads to depression and physical problems. The aim of this project is to develop a second-generation multi-talker, multi-listener (R) version of the original Companion Mics system. The original system allows one listener to hear three talkers with a 15-20 dB improvement in signal-to-noise ratio, which allows someone with a 10-20 dB "SNR loss" to carry on a conversation easily in a noisy situation. The goal of the second-generation design is to a) improve user acceptance by dramatically reducing the size and weight compared to the existing device, c) add the capability to allow two or more listeners to listen, c) increase ease of use by eliminating the need for the users to remember to turn the Listener Units on before the Talker Unit, d) reduce the latency below 32 mS. This will be pursued following the method of the first generation, which is extensive reprogramming of a Bluetooth chip set to allow more listeners and talkers and increase the bandwidth to 7.8 kHz and reduce the distortion of typical Bluetooth- programmed circuits to essentially zero. In order to obtain information that may help determine that a smaller device will be more acceptable, two university clinics, Pittsburgh University and the University of Iowa and one private clinic (Northwest Speech and Hearing in Illinois) have agreed to perform a series of experiments to: a) compare the impression of individuals from the public at large on several 7-point scales ("appears old" to "appears young," for example) to see if the smaller size is accompanied by a significantly better reaction to the devices as worn, b) investigate the degree of increased acceptance (if any) to physical models of the old and newer devices reduce the stigma of using the device c) obtain before and after measurements of benefit and satisfaction using several known scales including APHAB, SADL, COSI, GLASCO, PIADS, and DOSO. PUBLIC HEALTH RELEVANCE: Being left out of normal social interaction often leads to depression and physical problems. Approximately 10 percent of hearing aid wearers have a sufficient loss of ability to hear in noise that they are excluded from conversations at many restaurants and social gatherings where normal-hearing listeners themselves are forced to carry on conversations near the limit of their ability. The planned device will allow several talkers to be heard clearly by two listeners with severe hearing loss, listeners who would otherwise not be able to participate.